THE  HOSPITAL  LIBRARY  — 
BOOKS  FOR  THE 
PATIENTS 

Plea  for  a Trained  Librarian — Admin- 
istration— Selection  of  Books — Sepa- 
rate Children’s  Library — Library  Tech- 
nic— Distribution  of  Books — The  Li- 
brary as  an  Adjunct  to  Other  Depart- 
ments. 


By  EDITH  KATHLEEN  JONES, 

Librarian  McLean  Hospital,  Waverley,  Mass. 


REPRINTED  FROM 
THE  MODERN  HOSPITAL, 
October,  1915,  Vol.  V,  No.  4. 


ST.  LOUIS 

THE  MODERN  HOSPITAL  PUBLISHING  CO. 
1915 


Return  this  book  on  or  before  the 
Latest  Date  stamped  below.  A 
charge  is  made  on  all  overdue 
books. 

University  of  Illinois  Library 

t - 


M32— 30715 


TSGBfr' 


011'C*3 

I t 

O t * ' 

REMOTE  STORAGE 

THE  HOSPITAL  LIBRARY— BOOKS  FOR  THE 
PATIENTS1 


^ Plea  for  a Trained  Librarian — Administration — 
Selection  of  Books — Separate  Children’s 
Library — Library  Technic — Distribution 
of  Books — The  Library  as  an  Adjunct 
r to  Other  Departments. 

By  EDITH  KATHLEEN  JONES, 

Librarian  McLean  Hospital,  Waverley,  Mass. 

PERHAPS  no  other  branch  of  service  to  the 
public  has  grown  so  rapidly  in  the  last  few 
years  as  that  of  the  hospital.  Cities  and  states 
vie  with  each  other  in  maintaining  the  finest 
buildings,  the  most  efficient  equipment,  the  most 
prominent  staff  of  surgeons  and  physicians,  the 
best  training  schools  for  nurses ; private  hospitals 
and  sanatoriums  have  multiplied  throughout  the 
land.  All  departments  of  science  and  industry 
are  requisitioned,  not  only  to  care  for  the  imme- 
diate physical  needs  of  the  sick,  but  also  to  min- 
ister to  their  minds  and  train  their  hands  to  work 
which  may  enable  them  to  earn  their  livings  when 
dismissed  from  the  hospital  as  well  as  help  them 
over  many  tedious  hours  of  convalescence. 

With  the  baths  and  the  Zander  apparatus,  the 
diet  kitchen,  the  handicrafts  school,  the  social 
service  department,  all  commanded  by  experts, 
the  library  now  holds  an  important  place,  as  it 
becomes  more  generally  recognized  what  an  es- 
sential part  is  played  during  convalescence  by  the 
right  books  efficiently  administered.  The  old  idea 
of  a library  as  a mere  collection  of  books,  few  of 
intrinsic  value,  most  of  them  so  out  of  date  as  to 

iNext  month  there  will  be  published  a paper  on  The  Medical  Li- 
brary, by  Mrs.  Grace  Whiting  Myers,  Librarian,  The  Treadwell  Library, 
Massachusetts  General  Hospital. 


be  unreadable,  all  of  them  with  any  outer  attrac- 
tiveness they  may  possess  completely  disguised  in 
brown  paper  uniforms  and  arranged  on  the 
shelves  without  any  logical  sequence — a library 
which  runs  itself,  for  all  the  interest  anyone  takes 
in  it — this  old  idea  happily  is  passing.  The  mod- 
ern, up-to-date  hospital  knows  the  value  of  an 
equally  modern  and  up-to-date  library,  in  which 
new  books  that  people  want  to  read  are  purchased 
while  still  new,  and  taken  to  patients  who  will  be 
interested  or  benefited  by  them;  in  which  the 
librarian  co-operates  with  the  physician  and  the 
nurse  for  the  mental  and  therefore  physical  wel- 
fare of  the  patient. 

The  state  and  private  hospitals  for  mental  dis- 
eases have  long  recognized  the  need  of  books  in 
their  work,  even  though  comparatively  few  of 
them  have  had,  until  recent  years,  organized  li- 
braries. That  the  general  hospitals  also  are  con- 
vinced of  the  value  of  the  patients’  library  is 
shown  by  the  fact  that  in  the  plans  for  some  of 
the  new  hospitals  recently  erected,  that  depart- 
ment is  provided  for.  The  Burke  Foundation  for 
Convalescents,  at  White  Plains,  N.  Y.,  the  Robert 
Brigham  Hospital  for  Chronic  Cases  and  the  Peter 
Bent  Brigham  Hospital  of  Boston,  all  have  in- 
cluded libraries  as  a necessary  part  of  their  equip- 
ment. The  Boston  City  and  the  Massachusetts 
General  Hospitals  long  have  maintained  such 
libraries,  and  the  latter  is  planning  for  a bright, 
cheery  reading  room  and  library  for  patients  in 
its  new  administration  house,  as  well  as  for  a 
spacious  and  well  equipped  medical  library. 
Nearly  all  the  smaller  hospitals  have  books,  if  not 
organized  libraries. 

The  value  of  the  library  being  conceded,  the 
question  remains,  how  can  it  be  most  economic- 
ally created  and  efficiently  maintained? 


Without  doubt,  for  the  larger  hospitals,  general 
and  mental,  an  organized,  central  library,  with  a 
trained  and  experienced  librarian  in  charge  who 
shall  have  full  power  in  the  selection  and  buying 
of  books  from  a definite,  annual  appropriation, 
olfers  the  most  logical,  the  most  practical  and  the 
most  economical  solution  of  the  problem. 

A PLEA  FOR  THE  TRAINED  LIBRARIAN 

It  must  be  confessed,  however,  that  the  hos- 
pitals maintaining  such  libraries  are  not  many. 
They  may  have  books,  they  may  have  a central 
library ; but  in  most  cases  this  is  not  classified  or 
catalogued,  and  in  nine  cases  out  of  ten  there  is 
no  trained  librarian.  Just  why  the  hospitals,  of 
all  institutions,  who  require  experts  in  every 
other  department,  should  almost  invariably  ignore 
this  need  in  the  library,  has  long  been  a matter  of 
much  speculation  among  librarians.  It  cannot  be 
on  account  of  expense,  because — although  it  may 
leave  an  untrained  person  to  wrestle  as  best  she 
can  with  the  technical  problems  of  the  patients’ 
library — when  the  medical  library  requires  cata- 
loguing and  classifying,  the  hospital  almost  inva- 
riably calls  in  an  expert  from  outside — and  pays 
expert  prices.  Now  suppose  the  hospital  has  em- 
ployed a skilled  and  experienced  librarian  for  a 
few  weeks  and  has  got  its  medical  library  in  good 
working  order.  The  expert  goes.  New  books  ar- 
rive. Who  is  going  to  classify  and  catalogue 
these  ? Who  is  going  to  look  up  the  half-forgotten 
reference  for  the  doctor  who  is  working  on  an  im- 
portant case?  The  untrained  person  who  has 
charge  of  the  library — who,  whatever  her  other 
qualifications,  knows  nothing  of  library  technic 
and  probably  is  unacquainted  with  French  or 
German?  Or  must  an  outside  expert  again  be 
called  in — at  expert  prices  ? 


Instead  of  the  trained  librarian  in  the  hospital, 
who  can  manage  both  libraries,  what  have  we? 
Usually  a much  overworked  person  who  does 
wonderfully  well  under  great  handicaps,  but  who 
has  to  work  out  all  technical  problems  for  herself 
at  a great  waste  of  time  and  energy.  In  most 
cases  she  combines  the  care  of  the  library  with 
that  of  some  other  department — stenography, 
drugs,  handicrafts,  recreations,  or  social  service 
— either  one  of  which  really  requires  all  her  time 
and  thought  and  strength.  Here  is  what  almost 
invariably  follows:  1 job  which  takes  all  one’s 
energy  -f-  another  job  which  does  the  same  = 2 
jobs  half  done  -f-  1 worn-out  woman.  Does  the 
hospital  gain  or  lose  in  such  service? 

On  the  other  hand,  a trained  and  experienced 
librarian  has  at  her  fingers’  ends  the  technic 
which  seems  so  elaborate  and  hopeless  to  the  un- 
trained person.  Her  training  presupposes  a col- 
lege education  or  its  equivalent,  therefore  she  will 
know  something  of  French  and  German  and  be 
able  to  catalogue  foreign  medical  books  and  look 
up  references.  She  should  be  perfectly  capable  of 
taking  full  charge  of  both  libraries,  so  that  no 
outside  help  will  be  needed.  She  knows  editions, 
and  how  to  buy  books,  and  will  study  the  needs 
of  the  general  library  to  build  it  up  intelligently. 
Moreover,  from  her  superior  education,  she 
should  be  able  to  help  the  nurses  greatly  by  sug- 
gesting books  for  them  to  read  and  by  giving 
them  lectures  on  books  and  reading,  current 
events,  or  the  history  of  art.  Such  “culture 
courses”  are  invaluable  to  the  nurse  in  her  prac- 
tice and  already  are  being  made  a feature  in  cer- 
tain training  schools.  It  would  certainly  seem 
that  the  trained  librarian  is  worthy  of  her  hire. 


ADMINISTRATION 


Since  the  central  library,  with  books  loaned 
from  it  for  longer  or  shorter  periods  of  time  to 
wards  or  cottages  as  well  as  patients,  is  now  gen- 
erally conceded  to  be  much  more  efficient  in  its 
workings  than  the  old  bookcase  with  its  never- 
changing  books  on  the  wards,  this  subject  need 
, not  again  be  discussed.  The  next  question  is  of 

details  of  administration. 

In  the  first  place,  the  hospitals  fall  naturally 
* into  two  classes : those  for  general,  or  acute  phys- 

ical and  surgical  cases,  and  those  for  chronic  cases 
and  mental  diseases.  In  some  departments  the  two 
can  be  administered  by  the  same  methods,  but  the 
libraries  of  these  two  classes  call  for  quite  dis- 
similar treatment  in  certain  respects.  The  gen- 
eral hospital,  whose  patients  stay  only  for  a few 
days  or  weeks,  demands  a different  class  of  books 
and  a more  simple  technic  than  the  hospital  for 
mental  diseases  or  chronic  cases,  whose  patients 
often  are  detained  for  months  and  years. 

SELECTION  OF  BOOKS 

Naturally,  the  first  thing  to  be  considered  in 
either  the  general  or  the  mental  hospital  is  the 
selection  of  books  and  magazines.  It  is  especially 
important  to  subscribe  to  many  of  the  latter,  be- 
cause they  are  light  and  easy  for  weak  hands  to 
hold;  they  have  many  pictures  and  short  stories 
and  articles.  But  these,  with  few  exceptions, 
should  be  new  and  current  numbers.  If  there  is 
one  thing  that  those  responsible  for  the  selection 
of  reading  matter  for  hospitals  overlook,  it  is  that 
j even  though  the  personnel  of  the  patients  is  con- 

tinually changing,  the  books  in  the  library  are  not 
peculiar  to  that  library,  but  probably  have  been 
read  and  re-read  by  the  patients  before  coming  to 
the  hospital.  They  want  something  new.  They 


5 


want  the  latest  magazines  and  the  latest  fiction. 

Here  enters  the  question,  how  shall  these  new 
books  be  secured  and  who  shall  select  them  ? 
Usually  there  is  no  system  about  this ; there  is  no 
definite  fund  for  books;  a few  are  donated  from 
time  to  time,  and  the  superintendent  or  the  board 
of  lady  visitors  select  those  which  are  purchased. 
Without  going  into  the  pros  and  cons  of  this 
method,  perhaps  it  will  be  sufficient  to  say  that, 
in  every  case  known  to  the  writer,  that  hospital 
which  has  a definite  sum,  however  small,  with 
which  to  buy  books  as  they  are  published,  is  firmly 
convinced  that  this  is  the  only  solution  of  the  buy- 
ing problem,  and  those  librarians  are  happiest 
whose  trustees  allow  them  to  select  the  books, 
having  become  convinced  that  the  librarian,  who 
comes  in  contact  with  her  readers  and  quickly 
learns  the  sort  of  books  demanded,  is  therefore  a 
more  competent  judge  than  anyone  else  of  what 
should  be  in  the  library. 

The  librarian  knows  that  new  fiction  is  de- 
manded ; that  small,  light-weight  books  of  colored 
pictures  or  interesting  short  stories  are  eagerly 
taken;  that  her  foreigners’  eyes  light  up  with  joy 
at  the  sight  of  a readable  book  in  their  own  lan- 
guage. And  she  will  not  make  the  mistake  of  one 
lady  visitor,  who,  out  of  the  kindness  of  her  heart 
but  ignorance  of  books,  sent  in  an  indiscriminate 
order  to  her  bookseller  for  “some  books  in  Yid- 
dish.” The  books  came  and  were  duly  presented 
to  several  Jewish  patients  in  turn,  who  received 
them  politely  but  without  enthusiasm.  Finally 
the  librarian  asked  one  very  well-educated  and 
cultivated  Jew  to  tell  her  what  the  books  were 
about  and  why  no  one  read  them.  He,  hesitating 
for  fear  of  hurting  her  feelings,  explained  that 
they  were  Christian  Bible  stories  told  for  chil- 
dren ! 


For  the  general  hospital,  few  books  other  than 
fiction  and  pictures  will  be  much  in  demand  by 
patients,  though  books  of  travel  and  art  and  some 
of  the  best  out-of-doors  and  “nature”  essays 
should  be  on  hand  in  case  they  are  wanted,  but  in 
the  hospital  for  chronic  cases  or  mental  diseases, 
while  plenty  of  fiction  and  the  best  of  the  new 
novels  should  be  supplied,  the  other  departments 
also  should  be  built  up.  Travels,  history,  biog- 
raphy, art,  literature,  science,  sociology — all  these 
should  be  represented  by  the  best  books  for  the 
purpose  on  each  subject.  Books  dealing  with  cur- 
rent events  should  be  bought  as  published.  All 
sorts  of  persons  with  all  degrees  of  education  will 
be  found  in  these  hospitals,  and  their  tastes  must 
be  consulted,  although  great  care  must  be  taken 
that  morbid,  gruesome,  over-emotional  and  too 
sentimental  books  are  not  included  in  a library 
of  this  sort. 

The  children  must  be  especially  considered 
when  books  are  selected,  and  plenty  of  wholesome 
fairy  stories  and  animal  stories  and  books  of  ad- 
venture provided  for  them.2 

LIBRARY  TECHNIC 

The  books  having  been  selected,  the  next  thing 
is  to  arrange  them  on  the  shelves  in  some  logical 
order,  and  provide  some  sort  of  list  or  catalogue 
by  which  they  may  easily  be  found.  In  the  gen- 
eral hospital,  where  there  is  little  but  fiction,  any 
but  the  very  simplest  classification  is  manifestly 
absurd.  The  fiction  may  be  arranged  on  the 
shelves  alphabetically  by  authors,  by  means  of  the 
Cutter  author-table  to  three  figures,  and  what 
little  else  there  is — art,  travel,  etc. — may  be  in- 
dicated by  a class  figure  before  the  author  num- 

2There  has  recently  been  published  by  the  A.  L.  A.  Publishing  Board, 
78  E.  Washington  street,  Chicago,  an  annotated  List  of  Books  for  Boys 
and  Girls,  by  Miss  Hewins,  which  should  be  a great  help  in  providing 
reading  for  children  in  hospitals. 


ber.  It  is  generally  found  more  convenient  to 
keep  children’s  books  by  themselves.  It  is  doubt- 
ful if  any  catalogue  is  needed,  unless  for  the  sake 
of  the  librarian,  who  probably  will  know  every 
book  without  its  aid.  An  accession  book  may  be 
kept,  but  experience  has  shown  that  the  only 
really  essential  catalogue  is  a card  shelf  list : that 
is,  a card  for  each  book,  with  number,  author  and 
title,  arranged  in  drawers  or  boxes  according  to 
number. 

The  hospital  for  mental  diseases  presents  a dif- 
ferent problem.  Because  of  the  greater  number 
of  subjects  in  its  library  and  because  of  the  fact 
that  the  patients  probably  will  use  a catalogue  to 
some  extent  at  least,  the  library  technic,  while 
still  as  simple  as  possible,  will  of  necessity  be 
more  elaborate  than  in  the  general  hospital. 
Books  must  be  classified  and  catalogued  in  order 
to  be  easily  found  and  to  show  what  subjects  the 
library  owns.  Except  in  very  small  libraries  the 
shelf  list  will  not  be  enough. 

There  are  many  ways  of  charging  books,  but 
the  simplest  and  most  efficient  seems  to  be  by 
means  of  a book-pocket  pasted  on  the  inside  of 
the  back  cover  of  each  book,  on  which  the  date 
when  the  book  becomes  due  is  stamped;  a book- 
card  bearing  number,  title  and  author,  which  is 
kept  in  the  pocket  when  the  book  is  on  the  shelf 
and  is  inscribed,  when  taken  out,  with  the  ward 
letter  or  number  or  the  patient’s  name;  a box 
with  date-index  cards,  in  which  the  cards  of  the 
books  taken  out  are  placed  behind  the  correspond- 
ing date. 

The  question  of  covers  or  no  covers  on  library 
books  has  long  been  a burning  one.  Nearly  all 
the  public  libraries  have  now  discarded  the  paper 
covers,  realizing  how  much  more  attractive  are 
the  bright  book  covers.  Some  libraries  shellac 


their  children’s  books.  Little  by  little  the  insti- 
tutions are  adopting  the  new  method  of  discard- 
ing covers,  which  certainly  has  everything  to  rec- 
ommend it.  Theoretically,  books  get  soiled  by 
handling,  but  in  reality,  a modern,  hygienically 
conducted  hospital  with  its  scrupulously  clean 
patients,  would  seem  to  offer  the  least  possible 
i chance  for  contamination.  As  far  as  contagion 

goes,  old  books  are  usually  sent  to  the  contagious 
wards  and  then  burned.  There  is  really  less 
i chance  for  a book  to  acquire  dirt  or  germs  in  a 

hospital  than  in  the  ordinary  tenement  home  to 
which  so  many  public  library  books  are  loaned, 
but  if  it  is  a question  of  paper  uniforms  or  shellac 
— why  not  try  shellac?  It  can  be  washed. 

DISTRIBUTION  OF  BOOKS 

With  the  ordinary  library  routine  thus  reduced 
to  its  simplest  terms,  the  librarian  has  all  the 
more  time  at  her  disposal  for  getting  books  to  the 
patients.  That  hospital  which  can  make  of  its 
library  a pleasant  reading  and  lounging  room  ac- 
cessible to  all  but  bed  patients,  is  much  to  be 
envied.  McLean  Hospital  has  such  a central  li- 
brary, and  the  Burke  Foundation,  mentioned 
above,  is  a good  example  of  this  class  among  the 
general  hospitals.  They  have  there  about  600 
volumes,  400  of  which  are  in  the  main  library  and 
200  in  the  boys’  branch;  three-quarters  of  all 
these  are  fiction ; they  have  about  a hundred  books 
. of  pictures.  Patients  go  to  the  central  library  if 

they  are  able,  but  the  wards  and  cottages  are  kept 
well  supplied.  Although  this  hospital  is  so  very 
^ new,  patients  and  employees  are  using  the  library 

to  a degree  beyond  all  expectations. 

The  Massachusetts  General  Hospital  has  an  in- 
genious scheme  for  getting  books  to  its  patients. 
They  have  had  made  a small  hand-cart  just  the 

0 


10 


Library  cart,  in  use  in  the  Massachusetts  General  Hospital. 


height  of  the  beds.3  Every  afternoon  from  two 
till  three  the  librarian  spends  in  one  of  the  wards 
(taking  them  in  turn,  one  ward  each  day)  with 
this  little  cart  piled  full  of  books  suited  to  that 
ward;  the  cart  is  pushed  up  to  each  bed  and  the 
patients  thus  can  make  their  own  selections.  If 
they  ask  for  any  particular  book  not  in  the  cart, 
the  librarian  sees  that  it  is  sent  to  them.  Nurses 
i are  expected  to  help  the  librarian  by  calling  her  at- 

tention to  new  patients,  and  by  trying  to  interest 
their  patients  in  books. 

In  the  distribution  of  books  in  the  hospitals  for 
the  insane,  the  cooperation  of  the  nurses,  espe- 
cially the  head  nurses,  is  indispensable;  for  here 
are,  not  physically  ill  or  convalescent  patients 
with  a normal  outlook  on  life,  but  patients  whose 
inner  vision  is  distorted,  who  must  be  coaxed  and 
urged  to  interest  in  things  about  them.  With 
such,  it  is  not  enough  for  the  librarian  to  leave  a 
book ; the  nurses  must  see  that  it  is  not  destroyed 
and  must  try  to  arouse  interest  in  it.  Often  it  is 
the  nurse  who  finds  out  what  the  patient  really 
wants,  but  the  librarian  must  be  able  to  give  him 
just  that  sort  of  book.  There  is  much  oppor- 
tunity here  for  the  librarian  to  co-operate  with 
the  doctors  in  selecting  books  for  individual  cases 
— depressed,  delusional  or  excited. 

THE  LIBRARY  AS  AN  ADJUNCT  TO  OTHER 
DEPARTMENTS 

That  that  library  is  not  using  its  possibilities  to 
i the  fullest  extent  which  caters  only  to  its  patients, 

is  another  idea  which  is  gaining  ground.  Nurses 
and  other  employees  are  quick  to  respond  to  its 
1 privileges  offered  them,  and  the  nurses’  home 

might  well  be  considered  a branch  to  which  suit- 

3See  article  by  Dr.  F.  A.  Washburn,  entitled  “Hospital  Furniture  in 
Use  at  the  Massachusetts  General  Hospital,"  in  The  Modern  Hospital 
for  November,  1914.  (Vol.  Ill,  p.  335.) 


11 


able  books  are  loaned.  Of  course,  to  be  really 
valuable,  this  means  that  many  books  other  than 
fiction  must  be  bought. 

In  the  handicrafts  department,  the  library  can 
be  of  great  assistance  if  it  is  able  to  buy  books 
telling  how  to  make  baskets,  rugs,  pottery,  etc., 
and  books  and  periodicals  on  decoration  and  de- 
sign. McLean  Hospital  supplements  its  arts  and 
crafts  department  by  a card  catalogue,  jotting 
down  the  volume  and  page  of  some  particularly 
pleasing  shape  for  pottery  or  basket,  bit  of  or- 
namentation for  leather  work  or  wood  carving,  a 
hint  which  might  be  used  in  weaving.  Already 
this  catalogue  has  been  used  sufficiently  to  com- 
pensate for  the  little  trouble  it  is  to  make  it. 


1 


12 


4 


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4 

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